Sustainability Detriments and Outcomes across Samhsa-Funded Nonprofit Organizations

Background:

Approximately 40-75% of system-involved youth have untreated mental health issues. Moreover, up to one-third of justice youth meet criteria for a substance use disorder and those who experience substance use problems are more likely to remain in the system. More than 20% of programs addressing these mental health needs are nonprofit organizations (NPOs). These organizations are continually pressured to make a significant impact on the populations they serve and most of their funding is dependent on mission fulfillment. However, they may not successfully fulfill their mission if they are experiencing organizational capacity deficits. These deficits may lead to NPOs operating in a state of “hyper-efficiency,” which is the overexploitation of limited resources that can cause the organization to become structurally fragile and prevent innovation, stability, and sustainability. Thus, the purpose of the current study is to identify which organizational components are conducive to youth mental health program sustainability.

Methods:

The current study will use a subset of data derived from the parent study that examined sustainability detriments and outcomes across SAMHSA grantees. Organizations (n = 64) that were identified as having 501(c)(3) nonprofit status across five SAMHSA prevention grant initiatives.

A data reduction approach was used to find bivariate correlations between sustainability detriments (i.e., financial stability; organizational capacity; staff capability; implementation leadership; evaluation, feedback & program outcomes; responsiveness to community needs & values; and coalitions, partnerships, & networks) and total sustainment outcome, as guided by the Consolidated Framework for Implementation Research (CFIR). The sustainment detriments that were statistically significant in the bivariate analyses were retained and entered into the final multivariate model to explore which, if any, would remain significantly related to the sustainment outcome.

Results:

The sustainment outcome was significantly associated with five of the seven detriments: organizational capacity (r =0.41, p < 0.01), staff capability(r = 0.30, p < 0.05), evaluation, feedback, & program outcomes (r = 0.47, p < 0.001), responsiveness to community needs & values (r = 0.60, p < 0.001), and coalitions, partnerships, & networks (r = 0.35, p < 0.01).

The final model revealed that evaluation, feedback, & program outcomes and responsiveness to community needs & values were significantly related to the sustainment outcome. Overall, the model accounts for 48% of variance in sustainment outcomes across nonprofit organizations engaged in preventative efforts funded by SAMHSA F(5, 48) = 8.91, p < 0.001).

Implications:

The current study found several factors related to sustainment status but ultimately evaluation and organizational networks were significantly related to sustainment when entered into the final model. Nonprofit organizations may not have ample resources to dedicate to all areas of capacity, thus allocating limited resources strategically can help promote parsimonious sustainability. Future research is warranted to examine the extent to which these relationships are stable over time. Next steps should also include further exploration of specific organizational characteristics such as those related to the types of services offered, number of employees, and client characteristics to further explain the nature of sustainment detriments and outcomes.